Welcome to Nursing Practice at Mission Community Hospital

Mission Community Hospital prides itself in providing compassionate and quality healthcare. We believe that the center of our services is our patient. Caring is the hallmark of our institution. Nursing at Mission Community Hospital believes in its power that formulated a functional, visual framework for the delivery of its role, purpose, and principles.

Nursing care is channeled by nursing philosophy, theoretical outline, and by defined elements of nursing. These components marked the development of our model of care.
Patient – defined as the center and focus of our services.
Nursing Services – defined as integral element that supports an outstanding patient experience. They consist of:

  • General Medical and Surgical Services
  • Telemetry Services
  • Behavioral Health Services
  • Critical Care / Intensive Care Services
  • Emergency Services
  • Chemical Dependency Services
  • Intensive Outpatient Psychiatric Services
  • Infusion Services, and
  • Perioperative/Perianesthesia Services

Nursing Services at MCH believes in its values statement that we are dedicated to:

  • Respect and Compassion
  • Excellence and Quality
  • Honesty and Accountability, and
  • Continued Growth

As a community hospital, we see ourselves providing safe guidance to our patients and their families as they experience healthcare process; we see ourselves providing an encompassing service that is attentive to the total health needs of each individual. We, the Nurses at MCH dedicate ourselves in the furtherance of quality care through continued teamwork, leadership, collaboration, and participation in performance improvement.

Nursing Foundation and Structure

Nursing Services at MCH stands to cultivate professional maturity and facilitates professional growth. Therefore, the Nurses at MCH adopted the influential work of Patricia Benner entitled, “Novice to Expert” Benner’s interest blatantly discovers the professional development of nurses through establishment of stages of competencies, knowledge, proficiency, and expertise in providing effective and efficient care to patients. Learning is the basis of all knowledge, and knowledge is the key to success.

Another basis of growth and development was introduced by the “Dreyfus Model”, which Patricia Benner believes in. The conceptualization of the nursing practice focuses on the meaning of nursing to nurses – on how did we learn to acquire skills, knowledge, and behavior in providing care to our patients from basic, acute, emergent, and critical; how we understood caring for diseases and conditions; and how the progression of novice to expert.

We intend to describe the development of nursing clinical expertise in five stages as enumerated through the great work of Patricia Benner.

  1. Novice Nurses – described as beginner nurses, with little or no experience of the situation in which they are expected to perform. The novice nurse at MCH enters the care system as a student nurse whereby they acquire and obtain their related learning experiences through the joint guidance of our Professional Nurses and their Clinical Instructors.
  2. Advanced Beginner – they are the Professional Nurses who can demonstrate and fulfill acceptable standards of nursing care. Our advanced beginners recognize and identify elements of patient care situations, which require interventions. They acquire skill building capabilities up to the point where they may be interested in exploring a different practice setting, referred to as a “transitional nurse”.
  3. Competent Nurses – these are nurses who have been practicing for two to three years in the same clinical setting, and reflect on their nursing actions in terms of long-range plans for the patient. The competent nurse has a degree of mastery, which contributes greatly to patient outcome, satisfaction, and efficient clinical management. The patient care plan is based on analytical process, which encompasses experience, reflections, and contemplation of nursing practice; and is able to anticipate physician’s diagnostic treatments and orders.
  4. Proficient Nurses – perceive the patient situation as a whole and anticipate the usual patient outcomes. The nurse can easily identify the normal sequence of events from abnormal or emergent situations. Proficient nurses can recognize deterioration or change in patient’s condition or status prior to explicit signs and symptoms, and takes action to rescue the patient. The nurse has worked consistently with patients from three to five years.
  5. Expert Nurses – are nurses considered to have obtained enormous background of experience and an intuitive grasp of the situation, which lends itself to the immediate and holistic interpretation of the patient situation and creative interventions. Expert nurses view the patient situation with complex understanding, advocate for the patient, guide nurses at all levels, and serve as clinical leaders and standard bearers.

Mission Community Hospital determines health care practitioners with differentiated practice needs. Through this classification, the nursing leadership identifies the need for the types of educational offerings for nursing orientation, continuing education, and unit-based education. We encourage and reinforce the development of critical thinking skills, interpersonal skills, and technical skills. We strongly encourage mentoring and peer recognition. MCH fosters participation of nurses in performance improvement and the Mission Council.

Nursing Leadership

The nursing leadership of Mission Community Hospital is dedicated to establishing innovative ways to achieve excellence in nursing practice. Nurse leaders are keen to the needs and demands of our patients as well as our nurses.

The Nursing Leaders provide strategic direction for the discipline of nursing. They assure that appropriate resources are available for education, research and evidence-based practice initiatives. This includes but not limited to:

  • Creating a growth and development strategy for our nurses to continuously expand their knowledge base and develop their clinical/technical, critical thinking, and relationship management skills;
  • Creating an environment in which we are continuously seeking to improve actual work of the professional nurse; and
  • Creating an environment that supports quality outcomes that meet or exceed benchmarks.

Leadership skills are developed through participation in organizational development, mentoring, stewardship, and attendance to professional resources such as conferences and seminars.

Philosophy of Nursing

The Philosophy of Nursing is the foundation of our patient care delivery and follows the creed of the California Nurse Practice Act and the ANA Standards of Clinical Nursing Practice. The Nurses at MCH are committed to achieving excellence in clinical practice that reflects positive and outstanding patient experience that involve critical thinking, professional development, accountability, evidence-based practice and commitment to the community.

A Professional Nurse stands as a patient advocate, caring for the patient as a whole – his mind, body and spirit through the continuum of care. Our care extends beyond the institution into the community, as we provide our services to a variety of settings throughout the continuum of health across the life span.

We foster growth and development by establishing elements of trust, mutual respect, effective communication, and recognize all contributions by health care team members. We embrace superior ways in technology, leadership, and delivery of care systems that enhances nursing profession and practice.

Nursing Education

Education is the root of learning through processes established by various leaders in professional growth and development. We accomplish education through planned and systematic approach. We follow the promulgated standards of academic, continuing education, and in-service education. We integrate both formal and informal education with research and practice to meet the needs of practitioners at all levels.

Nursing education implements background and academic achievements as the framework of nursing practice at Mission Community Hospital. Nursing education is developed to a customized method, which aligns orientation, competency assessment, continuing education and in-services. We encourage our professional nurses to participate in the development of education programs.

Research Programs

We, at Mission Community Hospital spotlights and aspire to make evidence-based practice (EBP) the foundation of which nursing care is delivered, governed, evaluated and enhanced. Through the guidance and collaboration of physician leaders, we are able to provide advanced methods in the delivery of patient care and developed positive outcome.

Differentiated Practice Delivery System

Professional nurses at Mission Community Hospital support this system, which is guided the following principles:

Decision-making: Decisions are made on a per-shift basis by staff according to practice roles. Decisions are guided by license, job description and level of competency.

Work Load Allocation: Assignments are based on current regulation and guidance by the California Laws, job description, and competency of staff in meeting the demands and needs of the patient.

Communication: Communications are direct among caregivers. For Mission Community Hospital, communication is key to effective and efficient patient management. Transparency and interdepartmental efforts are made through careful planning of the patient’s activities to provide smooth flow throughout the continuum of care.

Management: Nurse Leaders assure that all staff are fulfilling their responsibilities according to their level of competency and scope of license, and are accountable for the care that they provide.
The Nursing Services at MCH embraces the care function. A defined responsibility, authority, and accountability are observed for all stakeholders in clinical practice.

Given these concepts of nursing practice at Mission Community Hospital, I encourage you to experience it first hand. Nursing is truly a vocation in which it is an imperative component in the equation of quality care and bridging the gap in health care disparities.
In conclusion, Mission Community Hospital’s Nursing Services provide utmost care to our patients and our community.
Please feel free to contact us. The Nursing Administration is here to support your needs, vision, and future goals.

Chief Nursing Officer

References:
American Nurses Association (1998)
Standards of Clinical Nursing Practice 2nd Edition.
American Nurses Association (2000)
Scope and Standards for Nursing Professional Development.

Benner, P. (2001)
From Novice to Expert, Excellence and Power in Clinical Nursing Practice.
Prentice Hall Health.

Benner, P, Tanner, C and Chesla, C (1996)
Expertise in Nursing Practice, Caring and Clinical Judgment and Ethics.
Springer Publishing Company